'Clean eating' trend has eating disorder specialists concerned

WATCH ABOVE: People who work in eating disorder groups report that their clients are often talking about "clean eating" and it has experts concerned they may be foregoing activities for worry about what they may eat.

Blogs, magazines and Instagram posts are full of pictures of colourful avocadoes, sweet potatoes and juices – all endorsing the “clean eating” movement.

Although healthy eating is a laudable goal, eating disorder experts are worried about the trend, saying that taking it too far can increase the risk of problematic eating habits.

“Often, ‘clean eating’ includes eating foods made at home from basic ingredients, instead of ultra-processed foods. This is a solid recommendation, but can be taken too far,” said Kate Comeau, a registered dietitian and spokesperson for Dietitians of Canada.

She cautions that many websites and blogs rely on personal stories and not scientific evidence for their recommendations. “’Clean eating’ is a vague and unscientific term that is used by bloggers, alternative health practitioners and others to categorize foods,” she said.

That categorization is what leads Kelsey Johnston, outreach and education co-ordinator for the National Eating Disorder Information Centre, to call it a “slippery slope.”

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“It sounds like it’s originated from a place of good intentions, wanting to eat well and nutritiously and what it has kind of evolved into is a movement that seems to be encouraging restricting many things from our diet,” she said.

“When we talk about clean foods, we are automatically implying that many foods are dirty.”

Johnston reports that people have called the NEDIC eating disorder helpline, saying they’re concerned about their loved ones’ adherence to clean eating, and asking for more information.

Debbie Berlin-Romalis, executive director of Sheena’s Place, a Toronto-based centre that hosts support groups for people with eating disorders, said that her clients talk about clean eating every day. “In all of our groups — every single one of our groups.”

“Everyone I’ve ever met who’s in recovery will tell you there’s this dichotomy that gets set up in your brain around good foods and bad foods. And the good foods are the foods they will allow themselves to eat, and the bad foods, there’s a list.”

For some people, “food becomes this primary source of self-worth and happiness and meaning.”

This is a problem when people are so preoccupied with what they can and can’t eat that they stop normal activities like attending family dinners or going to restaurants with their friends out of fear of eating the wrong thing, said Dr. Blake Woodside, medical director emeritus of Toronto General Hospital’s eating disorder program.

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“There are things in life that are supposed to be pleasurable, and one of them is eating and enjoying eating,” he said. “And if you spend all your time worrying about what you’re eating, and anxious about it, and afraid of food, that deprives you of one of life’s important pleasures and reduces your quality of life.”

For some people who have a genetic risk of anorexia, an overly-restrictive diet could even increase the chances they develop the mental illness, he said. Others might binge-eat the foods on their restricted list, according to Berlin-Romalis.

Food restrictions are often driven by fear and misunderstanding, said Woodside. People might read about a study linking processed meats to an increased risk of colon cancer, and interpret that as meaning that if they eat a bite of salami, they will get cancer – which is not the case.

And the news is often scary. “As we go along, the number of things that are associated with cancer, premature death, heart disease and so on become enormous. And so what are you supposed to do about that?”

Adopting a clean eating mentality is not automatically going to give someone an eating disorder. Everyone exists on a continuum in terms of their relationship to food, said Johnston. But she is worried about the trend.

To Berlin-Romalis, it’s all about balance. “I’ve had to learn through my own personal and professional experiences that there is no such thing as bad food. No such thing.”

“You should see the jaws drop when I say that in a group,” she added.

“Food should be delicious, enjoyable and nourishing — not boring or restrictive,” said Comeau.

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“As a dietitian, my role isn’t to tell individuals what they should or shouldn’t eat,” said Comeau. She tries to make people aware of the scientific evidence behind different food choices and find foods that will work for them.

Berlin-Romalis suggests people examine why they have decided to restrict their diets as it’s rarely just about the food. “Why do we assign such power to food? And what is it that’s going on in your life that makes you feel like you can only eat that?”

If you’re concerned about eating disorders or a loved one, NEDIC offers a free helpline: 1-866-633-4220